By Sinéad Nolan
There is no escaping it, the 2016 ‘State of Care’ report which was released this week by the Care Quality Commission was damning. On the positive side it has meant that we are now forced to look at the stark reality of care in the UK, and if possible do something to fix it. On the negative side we are left with an increasingly fragile system which is simply not fit for purpose. For anyone who hasn’t seen the report, it showed several shocking figures including that almost 1,500 care homes have closed over the past six years. The document also warns about the number of home care providers turning their back on council contracts. So what are the main problems facing care providers and the care community in general?
If home care providers are turning their back on council contracts there is usually one problem: money. The reality for most care providers is that mandatory trainings/supervisions for carers, providing core materials and paying office staff doesn’t come cheap. There are the other costs of running a small business such as rent and bills – add this to the fact that your carer must be paid a living wage and you can see how most care companies find it difficult to turn a profit. Frequently, a local council may offer a package of one half an hour visit per day – in this case the profit can be low or non-existent. Often if care companies take these very small packages, they are at risk of making a loss.
Man-hours versus outcome
The man-hours involved in providing this half hour visit are huge. It involves making phone calls, visiting the clients home, performing assessments and then writing up a lengthy, detailed person-centred care plan. The care companies then must debrief the new carer (for whom they had had to interview, train, DBS check and get references for). This short visit does also not include travelling time there and back home for the carer (for which they may only receive between 3 and 4 pounds for completing). The workload does not stop there – communication, monitoring the client, checking their daily notes and completing regular risk assessments are essential for safeguarding that client. When care agencies take on a client they also take on a responsibility – it means being able to provide cover when their allocated carer cannot make it, and being responsible if anything goes wrong.
So why are our systems under strain is it just government cuts – or is it also an increased need? Statistics are now showing it may be both. Simultaneous to the cuts is the increasing size of the ageing population. People are living longer, healthier lives. There is an increasing care workforce shortage, and signs are showing that technology will soon be picking up the slack. This is a controversial topic (at least when you get to the point where people are talking about care robots) yet assistive technology and technology itself seems to be the only light at the end of the tunnel in this current ageing population/care workforce shortage crisis.
Prioritising what works
The problem with the system seems to be that we are not prioritising funding in the right way. The irony of this cut in funding is that keeping people at home (rather than in hospital or anywhere else) is cheapest for the system, and time and time again evidence also shows people much prefer to stay at home. The cuts are also leading to dangerous and expensive bed blocking in our hospitals. So why are the funds being cut from the care sector when this is the sector that seems to make the most sense, not only from an ethical position, but from a monetary position too? Which begs the question: will we recover our country in care crisis? It seems, only time will tell.
Sinéad Nolan is the Research and Communications Officer for Three Sisters Care – a domiciliary care provider in London who are working on the CHIRON project.